下腰痛患者脑网络的动态功能连接

目的:探究下腰痛（LBP）患者脑网络功能连接的动态变化。方法:对20例LBP患者及20例健康志愿者进行静息态脑功能核磁共振扫描，采用连接数目熵（CNE）比较LBP患者与健康志愿者大脑的动态功能连接变化，分析LBP患者各独立脑区的功能灵活性与年龄和日本骨科协会（JOA）量表评分的相关性。结果:全脑水平，LBP患者CNE低于正常人（P＜0.05），显著改变的脑区集中在额叶皮层、颞叶皮层、皮质下核团及部分枕叶皮层。脑区水平，LBP 患者中AAL 15（r=-0.525 5,P=0.020 8）、AAL32（r=-0.529 2,P=0.019 8）、AAL41（r=-0.546 9,P=0.015 4）、AAL62（r=0.601 5,P=0.006 4）、AAL76（r=-0.513 3,P=0.024 6）、AAL89（r=0.461 9, P=0.046 5）和AAL90（r=0.508 5, P=0.026 2）与年龄有临床相关性。LBP患者AAL17（r=-0.499 1,P=0.029 6）、AAL 47（r=0.481 4, P=0.036 9）、AAL 82（r=-0.554 8, P=0.013 7）、AAL 90（r=-0.562 1, P=0.012 3）与临床JOA量表评分有相关性。结论:LBP患者全脑功能网络的功能灵活性是降低的。CNE动态功能连接的测量不仅为量化大脑活动的时间与空间行为提供了一个新的框架，而且可以探索LBP脑功能变化的机理。

Dynamic functional connectivity of brain networks in patients with low back pain

Objective To explore the dynamic functional connectivity of brain networks in low back pain (LBP) patients. MethodsThe resting-state functional magnetic resonance imaging was performed on 20 LBP patients and 20 normal controls. The dynamicfunctional connectivity between LBP patients and normal controls was compared using connectivity number entropy (CNE), andthe correlations between functional flexibility of each independent brain region in LBP patients and age and JOA scale score werealso analyzed. Results The CNE of LBP patients was lower than that of normal controls at the whole brain level (P<0.05), andthe brain regions with significant changes were concentrated in frontal cortex, temporal cortex, subcortical nucleus mass and partof occipital cortex. Locally, some brain regions such asAAL15 (r=-0.525 5, P=0.020 8),AAL32 (r=-0.529 2, P=0.019 8),AAL41(r=-0.546 9, P=0.015 4), AAL 62 (r=0.601 5, P=0.006 4), AAL 76 (r=-0.513 3, P=0.024 6), AAL 89 (r=0.461 9, P=0.046 5) andAAL90 (r=0.508 5, P=0.026 2) had clinical relevance to age, and others brain regions, includingAAL17 (r=-0.499 1, P=0.029 6),AAL 47 (r=0.481 4, P=0.036 9), AAL 82 (r=-0.554 8, P=0.013 7) and AAL 90 (r=-0.562 1, P=0.012 3), were correlated withJOA scale score. Conclusion The functional flexibility of brain networks in LBP patients is reduced at the whole brain level.The measurement of CNE for evaluating dynamic functional connectivity not only provides a new framework for quantifyingspatial and temporal behaviors of brain activity, but also can be used to explore the mechanism of brain function changes in LBPpatients.